| A case of mental change due to tsutsugamushi meningoencephalitis in the patient with liver cirrhosis |
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Kyoung Hwa Choi, In Hee Kim, Seong Hun Kim, Sang Wook Kim, Kyung Ae Lee, Won Suk Lee, Seung Ok Lee |
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| 간경변 환자에서 쯔쯔가무시 뇌수막염에 의한 의식 변화 1예 |
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최경화, 김인희, 김성훈, 김상욱, 이경애, 이원석, 이승옥 |
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| Abstract |
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A 58-year-old man with liver cirrhosis and diabetes mellitus presented with general weakness, fever, and mental change including disturbance of consciousness, behavior and personality change. Laboratory tests showed hyponatremia, hyperglycemia, but no hyperammonemia. His confused mental state did not improve, even after a lactulose enema and correction of the hyponatremia and hyperglycemia. Brain computed tomography, an electroencephalogram, and a cerebrospinal fluid exam were performed to evaluate the cause of mental change and persistent fever. The patient was diagnosed with tsutsugamushi meningoencephalitis through a serologic study and the existence of eschar. The patient recovered dramatically on the tenth hospital day after initiating intravenous macrolide. We report herein a patient with mental change due to tsutsugamshi meningoencephalitis who was difficult to diagnose because of underlying liver cirrhosis. |
| Key Words:
Liver cirrhosis; Tsutsugamushi disease; Meningoencephalitis |
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